How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $588.84 | Facility | None | $436.52 | $562.34 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $562.34 | Professional | None | $269.15 | $269.15 | $562.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $38.02 | Professional | RR · Rental | $26.92 | $26.92 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | UE · Used equipment | $199.53 | $199.53 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Facility | None | $630.96 | $630.96 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $562.34 | Facility | None | $354.81 | $363.08 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $2,454.71 | Professional | None | $269.15 | $363.08 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $676.08 | Professional | None | $346.74 | $457.09 | $676.08 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
United Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $457.09 | Professional | None | $144.54 | $275.42 | $457.09 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | 52 · Reduced service | $131.83 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $87.10 | Professional | 53 · Discontinued | $52.48 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $43.65 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $43.65 |
Where Indiana sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 44th of 51
$269
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.